As we continue our discussion of the planning process, one strategy to assist the client in achieving their desired outcome is to explore any possible obstacles or challenges that might come up. If these questions are asked, the client is likely to respond with a great deal of change talk. When momentum has been established, the client will also want to plan for any situations that might be distracting or that could get in the way of following through with their plan.
It is important if these questions are asked, to allow the client to come up with their own ideas of how they would get resolved. Make sure if the client begins raising concerns and problems that may arise, that they are also providing the solutions. It is a meaningful experience to collaborate with clients, but they need to be doing the heavy lifting since they know themselves and what would work best.
Below is an example from Miller and Rollnick of a client becoming clearer on their plan to improve their grades and ways for them to stay as focused as possible. Notice that the client is coming up with their own ideas of what would support them in accomplishing their plan:
INTERVIEWER: So let me see if I understand your plan. You definitely want to improve your grades, and to do that you know that you need to spend more time studying. What you’re thinking of doing is to set aside 2 hours every day except Saturday, from 6:00 to 8:00 PM., and do nothing but study during that time. Is that right?
CLIENT: Yes. I think that will help.
INTERVIEWER: It should help. You might need to do more, but this would be a very good start.
CLIENT: Definitely. If I did that, it would make a difference in my grades.
INTERVIEWER: OK. What could you do to stick with your plan better?
CLIENT: I’d need to work it out with my roommate not to bother me or play music during that time. Or maybe I’d have to go to the library or a coffee shop.
INTERVIEWER: Someplace where you can concentrate and not be distracted.
CLIENT: Right. It would be tempting to get distracted and not study.
INTERVIEWER: You know that about yourself, that you need to be in a place where you can focus. What else?
CLIENT: I get hungry, and it would be better if I had something to eat before I start.
By asking these questions, the client can troubleshoot and plan ahead. The client is able to think about what might happen when they begin to study each evening and how they can stay focused. In this example, the client is coming up with their own ideas and seems to have a good sense of the challenges they may encounter. This collaborative effort between clinician and client makes it much more likely that the client can succeed in improving their grades.
The clinician’s role in the planning process is to support the client in exploring what may work best for them, making the plan as specific as possible, and troubleshooting any additional obstacles that may come up. In next month’s blog, we will look at a planning scenario where there are several good options to choose from and how to prioritize them and decide. I hope everyone is doing as well as possible and you have opportunities to use and practice motivational interviewing.
For more information about Motivational Interviewing or related services, contact Steve Bradley-Bull, LCMHC, by phone, (919) 812-9203, or by email, steve_bradley-bull@med.unc.edu
UNC CFAR Motivational Interviewing 